The aim of this study was to compare outcomes after growth-friendly treatment for early-onset scoliosis (EOS) between patients with skeletal dysplasias versus those with other syndromes. We retrospectively identified 20 patients with skeletal dysplasias and 292 with other syndromes (control group) who had completed surgical growth-friendly EOS treatment between 1 January 2000 and 31 December 2018. We compared radiological parameters, complications, and health-related quality of life (HRQoL) at mean follow-up of 8.6 years (SD 3.3) in the dysplasia group and 6.6 years (SD 2.6) in the control group.Aims
Methods
Sensory profiles classified in Low Registration, Sensory Sensitive, Sensation Avoiding and Sensation Seeking may be used in patients with non-specific chronic low back pain (CLBP) to develop a more personalized treatment program. Although psychometric properties have not been studied up till now the Adult Adolescent Sensory Profile (AASP) can be used to measure sensory profiles in CLBP patients. The study aim was to asses internal consistency, test-retest reliability, agreement and construct validity of the AASP in a CLBP population with nociplastic pain.Introduction
Objectives
The aim of this study was to compare the outcomes of surgery
using growing rods in patients with severe A review of a multicentre EOS database identified 107 children
with severe EOS (major curve ≥ 90°) treated with growing rods before
the age of ten years with a minimum follow-up of two years and three
or more lengthening procedures. From the same database, 107 matched
controls with moderate EOS were identified.Aims
Patients and Methods
Primary cilia are singular structures containing a microtubule-based axoneme which are believed to not only be mechanosensitive but also to co-ordinate many cell functions via signalling pathways including Hedgehog and Wnt. Primary cilia have previously been described on cells of mouse intervertebral discs (IVDs), but not in bovine or human IVDs. Our aim was to examine primary cilia in these species. Nucleus pulposus cells were obtained from cows with no overt disc degeneration and patients following spine surgery (for herniations and/or degenerative disc disease) and cultured until confluent before maintaining with or without serum for 24h. Primary cilia were visualised with antibodies to the axoneme (acetylated α-tubulin and Arl13b) and/or the basal body (pericentrin) using fluorescent secondary antibodies and ≥200 cells per sample were counted.Introduction
Methods
We undertook a prospective non-randomised radiological study
to evaluate the preliminary results of using magnetically-controlled
growing rods (MAGEC System, Ellipse technology) to treat children
with early-onset scoliosis. Between January 2011 and January 2015, 19 children were treated
with magnetically-controlled growing rods (MCGRs) and underwent
distraction at three-monthly intervals. The mean age of our cohort
was 9.1 years (4 to 14) and the mean follow-up 22.4 months (5.1
to 35.2). Of the 19 children, eight underwent conversion from traditional growing
rods. Whole spine radiographs were carried out pre- and post-operatively:
image intensification was used during each lengthening in the outpatient
department. The measurements evaluated were Cobb angle, thoracic kyphosis,
proximal junctional kyphosis and spinal growth from T1 to S1.Aims
Patients and Methods
To compare static and dynamic lumbar intervertebral ranges of motion (IV-RoM) in patients with chronic, nonspecific low back pain with upper and lower cut off values derived from healthy controls when variability and measurement errors were reduced. Measurements from functional radiographs suffer from high variability and measurement errors, making cut off values for excessive or insufficient motion problematical. This study compared maximum lumbar IV-RoM and maximum IV-RoM at any point in continuous motion sequences in patients with chronic, non-specific back pain with upper and lower cut off values for L2 to L5 from matched controls using quantitative fluoroscopy, where variation and measurement errors were reduced. Participants underwent passive recumbent examinations in the sagittal and coronal planes. Values based on were developed for both maximum and continuous motion in controls (n=40). Fishers exact test was used to analyse proportions of patients whose IV-RoMs exceeded reference values. For maximum IV-RoM in patients, there were no statistically significant differences between groups for the lower value. Only flexion at L4/5 significantly exceeded the upper value (p=0.03). For continuous IV-RoM, left L3/4 (p=0.01) and right L4/5 (p=0.01) were significantly below the lower cut off values. Both flexion L4/5 (p=0.05) and left L3/4 (p=0.01) were significantly above the upper cut off values.Purpose and Background:
Methods and Results:
To audit the routine measurement of Vitamin B12 levels prior to cervical decompressive surgery Retrospective analysis of medical records and pathology results of patients who underwent decompressive cervical surgery for myelopathy over a 6 month period 26 patients were identified from theatre records. 21 out of 26 patients did not have vitamin B12 levels checked prior to their decompressive surgery The reports in the literature of co-existent B12 deficient myelopathy and mechanical compression are a cause for concern. Although the incidence of this is unknown and unlikely to be common, good clinical practice would suggest that we should be routinely monitoring B12 levels in myelopathic patients. We have introduced new standards for routinely checking B12 levels pre-operatively and intend to re-audit the effectiveness of these in six months time.
MRI scanning of spinal patients at the Primary Care Triage stage is pivotal in reducing inappropriate referrals into Secondary Care. A retrospective study was undertaken. Details of patients from spinal triage clinics referred for MRI scan were collated together with a provisional diagnosis. Following imaging the results and management plan were documented. 2191 Patients referred via GP's to Physiotherapy Specialist- lead spinal triage clinics from April to September 2009 inclusive. Referred to a spinal consultant routine/urgent, Managed conservatively, Failed to attend for MRI scanning or MRI cancelled, Sent for scanning for reassurance and discharged. Of 2191 patients seen in a 6-month period 194 (9%) were referred for MRI of which 81 (41%) were referred on to spinal consultant. This equates to 3.7% of the total number of patients triaged. Specialist physiotherapy diagnosticians with access to MRI scanning, allows simultaneous treatment and seamless transfer to spinal consultants for surgical intervention if appropriate1. This process is used effectively to manage large numbers of spinal referrals and minimises the number of patients seen unnecessarily in secondary care1. This is only possible with close multidisciplinary team working2.
Reviewing our experience of scoliosis in children with a Cavopulmonary Shunt or Fontan circulation and the cardiovascular challenges that this presents. A notes and x ray review was performed. Special attention was paid to the changes in cardiovascular status whilst prone. The review was from first presentation to latest follow up. There were 6 patients who underwent 7 major procedures between 2001 and 2009. All had cardiac procedures in early life. Both definitive fusion and growing instrumentation was used. All procedures were successful. Growing instrumentation allowed earlier primary surgery before completion of the Fontan circulation. All have been subsequently lengthened in a lateral position. The mean follow up is 56 months. There was one death 40 months following last surgery, cause unrelated to spinal surgery. In the older patients with a completed Fontan significant blood loss was seen, due to the raised venous pressure required to run the Fontan, and occult hypotension seen as a climbing difference between Pulmonary Artery Wedge Pressure and Central Venous Pressure were common when prone. We recommend early intervention, using instrumentation without fusion to correct the deformity over time and allow intervention prior to completing the Fontan circulation. As haemodynamic instability increases with increasing time in the prone position, surgery should be expedited rapidly.
